Skip to main content
Erschienen in: World Journal of Urology 7/2019

15.10.2018 | Original Article

Can contrast-enhanced ultrasound and acoustic radiation force impulse imaging characterize CT-indeterminate renal masses? A prospective evaluation with histological confirmation

verfasst von: Wolfgang M. Thaiss, Jens Bedke, Stephan Kruck, Daniel Spira, Arnulf Stenzl, Konstantin Nikolaou, Marius Horger, Sascha Kaufmann

Erschienen in: World Journal of Urology | Ausgabe 7/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To prospectively characterize computed tomography (CT)-indeterminate renal masses (CTIRM) using acoustic radiation force impulse (ARFI) elastography and contrast-enhanced ultrasound (CEUS) and to correlate quantitative imaging findings with histopathology or interim follow-up (FU).

Methods

123 patients with CTIRM (longest diameter < 4 cm) underwent ARFI and CEUS with CT image fusion (IF). Exclusion criteria included all contraindications for CEUS and IF. Shear wave velocity (SWV), shear wave ratio (SWR), peak intensity (PE), time to peak (TTP) and wash-in rate (Wi) were quantified. In case of a cystic lesion classified as ≤ Bosniak 2F, follow-up imaging was performed.

Results

77 out of 123 patients underwent surgical resection of a lesion due to suspect imaging findings, whereas 46 patients underwent FU, which did not show upgrading in Bosniak category. Histopathology revealed 58 renal cell carcinomas [five chromophobe (chRCC), 18 papillary (pRCC) and 35 clear cell (ccRCC)], ten oncocytomas and nine non-malignant renal lesions (one minimal fat AML, three focal nephritis and five infected cysts). SWV and SWR differed significantly between ccRCC, pRCC, chRCC (p = 0.0024, F = 13.94) and in SWR also for oncocytoma (p < 0.0001, F = 14.35). In CEUS, oncocytoma and ccRCC showed significant higher PE values (p < 0.0001, F = 77.31) as well as higher Wi and lower TTP compared to all other solid lesions.

Conclusions

Quantitative CEUS and ARFI imaging can provide relevant information to further characterize CT-indeterminate renal masses to guide urological decision making and offer the possibility of differentiation between ccRCC from less malignant RCC subtypes and from oncocytoma.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
9.
Zurück zum Zitat Prasad SR, Humphrey PA, Catena JR, Narra VR, Srigley JR, Cortez AD, Dalrymple NC, Chintapalli KN (2006) Common and uncommon histologic subtypes of renal cell carcinoma: imaging spectrum with pathologic correlation. Radiogr Rev Publ Radiol Soc N Am Inc 26(6):1795–1806. https://doi.org/10.1148/rg.266065010 CrossRef Prasad SR, Humphrey PA, Catena JR, Narra VR, Srigley JR, Cortez AD, Dalrymple NC, Chintapalli KN (2006) Common and uncommon histologic subtypes of renal cell carcinoma: imaging spectrum with pathologic correlation. Radiogr Rev Publ Radiol Soc N Am Inc 26(6):1795–1806. https://​doi.​org/​10.​1148/​rg.​266065010 CrossRef
13.
Zurück zum Zitat Finelli A, Ismaila N, Bro B, Durack J, Eggener S, Evans A, Gill I, Graham D, Huang W, Jewett MA, Latcha S, Lowrance W, Rosner M, Shayegan B, Thompson RH, Uzzo R, Russo P (2017) Management of small renal masses: American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol 35(6):668–680. https://doi.org/10.1200/jco.2016.69.9645 CrossRefPubMed Finelli A, Ismaila N, Bro B, Durack J, Eggener S, Evans A, Gill I, Graham D, Huang W, Jewett MA, Latcha S, Lowrance W, Rosner M, Shayegan B, Thompson RH, Uzzo R, Russo P (2017) Management of small renal masses: American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol 35(6):668–680. https://​doi.​org/​10.​1200/​jco.​2016.​69.​9645 CrossRefPubMed
16.
Zurück zum Zitat Clevert DA, Stock K, Klein B, Slotta-Huspenina J, Prantl L, Heemann U, Reiser M (2009) Evaluation of acoustic radiation force impulse (ARFI) imaging and contrast-enhanced ultrasound in renal tumors of unknown etiology in comparison to histological findings. Clin Hemorheol Microcirc 43(1–2):95–107. https://doi.org/10.3233/ch-2009-1224 CrossRefPubMed Clevert DA, Stock K, Klein B, Slotta-Huspenina J, Prantl L, Heemann U, Reiser M (2009) Evaluation of acoustic radiation force impulse (ARFI) imaging and contrast-enhanced ultrasound in renal tumors of unknown etiology in comparison to histological findings. Clin Hemorheol Microcirc 43(1–2):95–107. https://​doi.​org/​10.​3233/​ch-2009-1224 CrossRefPubMed
17.
Zurück zum Zitat Goya C, Daggulli M, Hamidi C, Yavuz A, Hattapoglu S, Cetincakmak MG, Teke M (2015) The role of quantitative measurement by acoustic radiation force impulse imaging in differentiating benign renal lesions from malignant renal tumours. Radiol Med (Torino) 120(3):296–303. https://doi.org/10.1007/s11547-014-0443-7 CrossRef Goya C, Daggulli M, Hamidi C, Yavuz A, Hattapoglu S, Cetincakmak MG, Teke M (2015) The role of quantitative measurement by acoustic radiation force impulse imaging in differentiating benign renal lesions from malignant renal tumours. Radiol Med (Torino) 120(3):296–303. https://​doi.​org/​10.​1007/​s11547-014-0443-7 CrossRef
18.
Zurück zum Zitat Tamai H, Takiguchi Y, Oka M, Shingaki N, Enomoto S, Shiraki T, Furuta M, Inoue I, Iguchi M, Yanaoka K, Arii K, Shimizu Y, Nakata H, Shinka T, Sanke T, Ichinose M (2005) Contrast-enhanced ultrasonography in the diagnosis of solid renal tumors. J Ultrasound Med 24(12):1635–1640CrossRefPubMed Tamai H, Takiguchi Y, Oka M, Shingaki N, Enomoto S, Shiraki T, Furuta M, Inoue I, Iguchi M, Yanaoka K, Arii K, Shimizu Y, Nakata H, Shinka T, Sanke T, Ichinose M (2005) Contrast-enhanced ultrasonography in the diagnosis of solid renal tumors. J Ultrasound Med 24(12):1635–1640CrossRefPubMed
23.
Zurück zum Zitat Harvey CJ, Alsafi A, Kuzmich S, Ngo A, Papadopoulou I, Lakhani A, Berkowitz Y, Moser S, Sidhu PS, Cosgrove DO (2015) Role of US contrast agents in the assessment of indeterminate solid and cystic lesions in native and transplant kidneys. Radiogr Rev Publ Radiol Soc N Am Inc 35(5):1419–1430. https://doi.org/10.1148/rg.2015140222 CrossRef Harvey CJ, Alsafi A, Kuzmich S, Ngo A, Papadopoulou I, Lakhani A, Berkowitz Y, Moser S, Sidhu PS, Cosgrove DO (2015) Role of US contrast agents in the assessment of indeterminate solid and cystic lesions in native and transplant kidneys. Radiogr Rev Publ Radiol Soc N Am Inc 35(5):1419–1430. https://​doi.​org/​10.​1148/​rg.​2015140222 CrossRef
25.
Zurück zum Zitat Clevert DA, Minaifar N, Weckbach S, Jung EM, Stock K, Reiser M, Staehler M (2008) Multislice computed tomography versus contrast-enhanced ultrasound in evaluation of complex cystic renal masses using the Bosniak classification system. Clin Hemorheol Microcirc 39(1–4):171–178PubMed Clevert DA, Minaifar N, Weckbach S, Jung EM, Stock K, Reiser M, Staehler M (2008) Multislice computed tomography versus contrast-enhanced ultrasound in evaluation of complex cystic renal masses using the Bosniak classification system. Clin Hemorheol Microcirc 39(1–4):171–178PubMed
Metadaten
Titel
Can contrast-enhanced ultrasound and acoustic radiation force impulse imaging characterize CT-indeterminate renal masses? A prospective evaluation with histological confirmation
verfasst von
Wolfgang M. Thaiss
Jens Bedke
Stephan Kruck
Daniel Spira
Arnulf Stenzl
Konstantin Nikolaou
Marius Horger
Sascha Kaufmann
Publikationsdatum
15.10.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
World Journal of Urology / Ausgabe 7/2019
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-018-2520-3

Weitere Artikel der Ausgabe 7/2019

World Journal of Urology 7/2019 Zur Ausgabe

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.